Ani Sensörinöral İşitme Kaybı Olan Hastalarda Tıbbi Tedavinin Etkinliği

Abstract

Objective: Management of sudden sensorineural hearing loss still remains unclear in otology. To evaluate our experience medical management of sudden hearing loss with review of the literature. Materials and Methods: In this study, we performed retrospective chart review including 60 patients presenting sudden sensorineural hearing loss (SSNHL) between 2008-2018 years. We included only patients given medical management, and hyperbaric oxygen was not performed in any patients. Pure tone audiometric measurements investigated before (PTA I) and after treatment at two weeks (PTA II) and three months (PTA III). We also performed cranial MRI on all patients to disclose intracranial pathology if it was present. Results: The mean age of our cases of was 49.7 years. No certain etiology was detected in all patients in the study. The improvement of hearing loss in our cases was classified according to Siegel's criteria as follows: Type I (3.3%) in 2 patients, Type II (16.7%) in 10 patients, Type III (33.3%) in 20 patients, Type IV (28) in 28 patients (46.7%). Three mean audiometric measurements were compared statistically with each other (PTA I and PTA II: p <0.05; PTA I and III: p <0.05, PTA II and III: p <0.05). Conclusion: In current study, we found that 60 patients diagnosed as SSNHL and given only medical treatment had positive satisfactory hearing improvement who was observed mainly in that patients with moderate to severe hearing loss and younger ones; however, these results require prospective studies involving a large number of patients.

Keywords

• Sudden hearing loss
• sensorineural hearing loss
• drug therapy management

Effectiveness of Medical Management of the Patients with Sudden Sensorineural Hearing Loss

Abstract

Amaç: Ani sensörinöral işitme kaybının tedavisi otolojide hala belirsizliğini korumaktadır. Bu çalışmanın amacı ani işitme kaybının tıbbi yönetimi konusundaki deneyimlerimizi literatür eşliğinde değerlendirmektir. Gereç ve Yöntemler: Bu çalışmada 2008-2018 yılları arasında ani sensörinöral işitme kaybı olan 60 hastadan oluşan retrospektif inceleme tablosu yaptık. Sadece tıbbi tedavi verilen hastaları dahil ettik ve hiçbir hastaya hiperbarik oksijen uygulanılmadı. Saf ses odyometrik ölçümler tedaviden önce (PTA I), ve tedaviden sonra ikinci hafta (PTA II) ve üçüncü ayda (PTA III) yapıldı. Eğer varsa intrakranial bir patolojiyi ortaya çıkarmak için tüm hastalara kranial MRI uygulandı. Bulgular: Hastaların ortalama yaşı 49.7 idi. Hastaların hiç birinde etiolojik sebep saptanmadı. Olgularımızın işitme kaybının düzelmesi Siegel'in kriterlerine göre şu şekilde sınıflandırıldı: 2 hastada Tip I (% 3.3), 10 hastada Tip II (% 16.7), 20 hastada Tip III (% 33.3), 28 hastada Tip IV (28) % 46.7). Üç ortalama odyometrik ölçüm birbiriyle istatistiksel olarak karşılaştırıldı (PTA I ve PTA II: p <0,05; PTA I ve III: p <0,05, PTA II ve III: p <0,05). Sonuç: Güncel çalışmamızda ani sensörinöral işitme kaybı teşhis edilen ve sadece medikal tedavi alan 60 hastanın esas olarak orta-şiddetli işitme kaybı olanlarında ve genç olanlarında olumlu tatminkar iyileşme gözlendiğini saptadık; ancak bu sonuçlar çok sayıda hasta içeren prospektif çalışmalara ihtiyaç duymaktadır.

Keywords

• Ani işitme kaybı
• sensörinöral işitme kaybı
• tıbbi tedavi uygulaması

References

1. 1References 1. 1. Psifidis AD, Psillas GK, Daniilidis JCh. Sudden sensorineural hearing loss: Long-term follow-up results. Otolaryngol Head Neck Surg 2006;134(5):809-15.
2. 2. DeKleyn A. Sudden complete or partial loss of function of the octavus-system in apparently normal person. Acta Otolaryngol 1944;32:407-25.
3. 3. Körpinar S, Alkan Z, Yiğit O, Gör AP, Toklu AS, Cakir B, et al. Factors influencing the outcome of idiopathic sudden sensorineural hearing loss treated with hyperbaric oxygen therapy. Eur Arch Otorhinolaryngol. 2011 Jan;268(1):41-7.
4. 4. Lazarini PR and Camargo AC. Idiopathic sudden sensorineural hearing loss: etiopathogenic aspects. Rev Bras Otorrinolaringol 2006;72(4):554-61.
5. 5. Yildiz Z, Ulu A, Incesulu A, Ozkaptan Y, Akar N. The Importance of Thrombotic Risk Factors in the Development of Idiopathic Sudden Hearing Loss. Clin Appl Thromb Hemost 2008;14(3):356-9.
6. 6. Siegel LG. The treatment of idiopathic sudden sensorineural hearing loss. Otolaryngol Clin North Am. 1975 Jun;8(2):467-73.
7. 7. Wilson WR, Byl FM, Laird N. The efficacy of steroids in the treatment of idiopathic sudden hearing loss: a double-blind clinical study. Arch Otolaryngol 1980;106:772– 6.
8. 8. Yeo SW, Lee DH, Jun BC, Park SY, Park YS. Hearing outcome of sudden sensorineural hearing loss: Long-term follow-up. Otolaryngol Head Neck Surg 2007;136(2):221-4.

9. 9. Slattery WH, Fisher LM, Iqbal Z, Liu N. Oral steroid regimens for idiopathic sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2005;132(1):5-10.
10. 10. Lan WC, Wang CY, Lin CD. Pentoxifylline versus Steroid Therapy for Idiopathic Sudden Sensorineural Hearing Loss with Diabetes. J Int Adv Otol. 2018 Aug;14(2):176-180.
11. 11. Stachler RJ, Chandrasekhar SS, Archer SM, Rosenfeld RM, Schwartz SR, Barrs DM, et al. Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg. 2012 Mar;146(3 Suppl):S1-35.
12. 12. Berjis N, Soheilipour S, Musavi A, Hashemi SM. Intratympanic dexamethasone injection vs methylprednisolone for the treatment of refractory sudden sensorineural hearing loss. Adv Biomed Res. 2016 Jun 20;5:111.
13. 13. Aoki D, Takegoshi H, Kikuchi S. Evaluation of super-high-dose steroid therapy for sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2006;134(5):783-7.
14. 14. O'Malley MR and Haynes DS. Sudden hearing loss. Otolaryngol Clin North Am 2008;41(3):633-49.
15. 15. Bennett MH, Kertesz T, Perleth M, Yeung P, Lehm JP. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database of Syst Rev 2012, Oct 17;10: CD004739.
16. 16. Cvorović L, Deric D, Probst R, Hegemann S. Prognostic Model for Predicting Hearing Recovery in Idiopathic Sudden Sensorineural Hearing Loss. Otol Neurotol 2008;29(4):464-9.
17. 17. Nosrati-Zarenoe R, Arlinger S, Hultcrantz E. Idiopathic sudden sensorineural hearing loss: results drawn from the Swedish national database. Acta Otolaryngol 2007;127:1168-75.
18. 18. Fujimura T, Suzuki H, Shiomori T, Udaka T, Mori T. Hyperbaric oxygen and steroid therapy for idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2007;264(8):861–6.
19. 19. Cheng YF, Chu YC, Tu TY, Shiao AS, Wu SL, Liao WH. Modified Siegel's criteria for sudden sensorineural hearing loss: Reporting recovery outcomes with matched pretreatment hearing grades. J Chin Med Assoc. 2018 Nov;81(11):1008-12.